Synopsis
Use structured education, individualised nutrition and safe physical activity to build practical diabetes self-management without stigma, unsafe restriction or preventable hypoglycaemia.
- Offer evidence-based structured education at diagnosis, with annual reinforcement and access when circumstances change; an information leaflet alone is not structured education.
- Type 1 education should teach carbohydrate estimation, insulin adjustment, hypoglycaemia, ketones, exercise, alcohol, driving and technology; flexible insulin therapy depends on these skills.
- Type 2 education should explain glucose, cardiovascular risk, medicines, food patterns, activity, monitoring, complications and achievable goals within the person's culture and resources.
Key red flags
Insulin or sulfonylurea use, prolonged aerobic activity, alcohol, reduced carbohydrate and previous episodes increase risk during exercise and overnight; delayed hypoglycaemia is commonly missed.
Investigation priorities
Identify actual intake, timing, access, culture and priorities.
Management branches
New diabetes, major treatment change or difficulty managing safely.
- Teach immediate priorities first: medicine identification, hypoglycaemia, ketones where relevant, glucose monitoring, driving, who to contact and what must never be stopped.
- Refer to a locally commissioned quality-assured programme suited to diabetes type, language, literacy, sensory needs, culture, schedule and digital access.
Key medicines
Rapid-acting carbohydrateCarry and use the individually taught measured amount when glucose is low.
Insulin exercise adjustmentReduce bolus or basal delivery using the structured programme's individual algorithm.